Small Intestinal Bacterial Overgrowth A Problem For Scleroderma Patients PDF Print E-mail
Tuesday, 02 July 2013 21:31
More than a third of patients with systemic sclerosis and intestinal symptoms have an increase in gastrointestinal tract bacteria, an alteration in the type of gut microbes present, or both, based on data from a French study presented at the annual European Congress of Rheumatology.

Small intestinal bacterial overgrowth (SIBO) was found to affect 14 (38%) of 37 patients included in the study. These patients had been recruited from a larger group of 120 scleroderma patients who complained of gastrointestinal symptoms over a 2-year period. "SIBO can compromise patients’ quality of life and be responsible for mortality," study investigator Dr. Marie Tauber said. SIBO can cause GI symptoms such as bloating, diarrhea, malabsorption, weight loss, and malnutrition, which may have a significant impact on patients’ overall prognosis, she noted.

Dr. Tauber, a dermatologist who took part in the research as part of an internship within the rheumatology department of the Hôpital Cochin in Paris, explained the three goals of the study. The first was to examine the prevalence of SIBO in patients with systemic sclerosis exhibiting GI symptoms, and the second was to identify subsets of patients who might be at increased risk. A third goal was to observe the impact of optimal SIBO treatment on the patients’ conditions.

The median age of participants was 59 years, and 79% were women. The median disease duration was approximately 10 years, and 49% of patients had diffuse cutaneous disease. A diagnosis of SIBO was based on positive hydrogen and methane breath tests, and blood assays were used to assess the presence of malabsorption.

The researchers also administered two questionnaires – the generic SF-36 (Short Form 36) Health Survey and the disease-specific UCLA SCTC GIT (University of California, Los Angeles, Scleroderma Clinical Trial Consortium Gastrointestinal Tract Instrument) – to patients at the time of their breath testing visits.

All patients with SIBO were treated with a rotating regimen of amoxicillin, ciprofloxacin, and metronidazole, each given for 1 month at a time. Breath tests, as well as the UCLA SCTC GIT, were repeated. Fewer than 50% of patients had a negative breath test after antibody treatment, which highlighted a need to repeat the test after antibiotic treatment to determine whether a second course is required, Dr. Tauber noted.

Three clinical parameters separated patients with and without SIBO: longer disease duration (11 vs. 7 years; P = .02), lower prevalence of anti-topoisomerase I antibodies (Anti-Scl-70 Ab, 7% vs. 39%; P = .04), and higher prevalence of definite pulmonary arterial hypertension (PAH, 21% vs. 0%; P = .04). Total UCLA SCTC GIT scores were higher in patients with SIBO than in those without it (0.79 vs. 0.31; P = .03). SIBO-affected patients also were more likely to have weight loss of 5% or more (43% vs. 8%; P = .03).

Given the small number of patients, it is difficult to draw firm conclusions from these data, and larger studies are needed, Dr. Tauber observed. However, the findings suggest that there may be factors associated with SIBO that could be targeted in an intervention program.

Source: Family Practice News
 
More articles :

» New Promising Therapy Against Systemic Sclerosis

There is a new path to defeat systemic sclerosis, also called because of the hardening of the skin of the patients (from Greek skleros, "hard", and derma, "skin"). This path involves the B-cell of the immune system, so far only considered "innocent...

» Nutrition Is Key To Combatting Your Autoimmune Disease

Every day, your protects you by attacking invaders such as bacteria and viruses. But when something goes awry with the body's immune system, immune cells may attack and damage tissues they were designed to protect, resulting in an autoimmune...

» GERD and Scleroderma

is an autoimmune disease that causes the skin, and sometimes other organs of the body, to become hard and thick. In the diffuse form of scleroderma, the esophagus and gastrointestinal tract are often affected. GERD, or gastroesophageal reflux...

» Dermatomyositis

Dermatomyositis is one of a group of muscle diseases known as the inflammatory myopathies, which are characterized by chronic muscle inflammation accompanied by muscle weakness. Dermatomyositis’ cardinal symptom is a skin rash that precedes or...

» Women and Autoimmunity

50:1, 9:1, 2:1 these are just some ratios of autoimmune disease disparities between women and men. The Society for Women’s Health Research (SWHR) hosted the Capitol Hill briefing, The War Within: Women and Autoimmunity, on Tuesday, October 11 to...

» Our Donors

The Scleroderma Care Foundation wishes to express our appreciation and gratitude for the generosity and support extended to us, by all of our donors to date, and the list keeps on growing. Your contributions have all been incredibly helpful and...